多模态磁共振成像对宫颈癌病理分级和分期评估中的应用

Application of multimodal magnetic resonance ima1ging in the evaluation of pathological grading and staging of cervical cancer

目的探讨多模态磁共振成像评估宫颈癌病理分级和分期的应用价值。方法选取我院32例宫颈癌患者进行回顾性研究,均行MRI平扫、T1mapping及DCE-MRI检查,以术后病理分级及分期进行分组。观察指标包括:表观扩散系数(ADC)、T_(1)值、容积转运常数(K^(trans))和速率常数(K_(ep)),使用受试者工作特征曲线(ROC)评价各参数诊断效能。结果早期宫颈癌的T_(1)值高、容积转运常数值低,有利于磁共振对宫颈癌分期的判断;T_(1)、ADC及容积转运常数值诊断宫颈癌病理分级的AUC值分别为0.83、0.74和0.79,三者联合的AUC值为0.91。结论术前采用多模态磁共振可以初步判断宫颈癌的病理分级和分期,T_(1)值、ADC及容积转运常数(K^(trans))均具有较高的诊断效能,三者联合检测的诊断效能明显提升。

Objective To analyze the application value of multimodal magnetic resonance imaging to assess the pathological grading and staging of cervical cancer.Methods Thirty-two patients with cervical cancer from November 2018 to October 2021 in Taihe County People's Hospital were collected for a retrospective study,and all patients underwent MRI plain,T1mapping and DCE-MRI before surgery,and were grouped by postoperative pathological grading and staging.Observations included apparent diffusion coefficient(ADC),T_(1)value,volume transfer constant(K^(trans))and rate constant(K_(ep)),and the diagnostic efficacy of each parameter was evaluated using the subject operating characteristic curve(ROC).Results High T_(1)values and low volume transfer constant values in early-stage cervical cancer facilitated the determination of cervical cancer staging by MRI;the AUC values of T_(1),ADC and volume transfer constant values for the diagnosis of cervical cancer pathological grading were 0.83,0.74 and 0.79,respectively,and the AUC value of the combination of the three was 0.91.Conclusion Preoperative multimodal MRI can be used to initially determine the pathological grading and staging of cervical cancer.The T_(1)value,ADC and volume transfer constant(K^(trans))all hare high diagnostic efficacy,and the diagnostic efficacy of the combined test of the three is significantly improved.